Rubella (German measles) in pregnancy

• What is rubella?

  • Rubella (German measles) is an infection that is caused by a virus. It is less serious than red measles, except in pregnant women.

  • Rubella usually causes a low-grade fever and mild cold-like symptoms followed by a rash. Glands in the neck may swell up. The sickness lasts for about 3 days.

  • People often do not know they have rubella because the disease is so mild. Their doctor may tell them they likely have rubella, but only a blood test can tell for certain.

  • Rubella is now rare in Canada because most children are vaccinated against it (as part of the measles-mumps-rubella [MMR] vaccine).

How does rubella spread?

Rubella spreads by close contact among people, such as living in the same house or sharing an office. Sneezing and coughing can spread rubella. You are very unlikely to catch rubella in a shopping mall or in crowded areas.

What about pregnant women and rubella?

Fortunately, rubella in pregnancy is now a rare problem in Canada because most women have been vaccinated against it. The vaccine prevents most – but not all–rubella infections during pregnancy.

If a pregnant woman is not immune to rubella and catches it during the first 5 months of pregnancy, she usually passes the disease on to her fetus.

• If the fetus gets rubella during the first 12 weeks of pregnancy, the baby will likely be born with many problems. The most common are eye problems, hearing problems and heart damage.

• If the fetus gets rubella between 12 and 20 weeks of pregnancy, problems are usually milder.

• If the fetus gets rubella after 20 weeks of pregnancy, there are usually no problems.

There is no treatment for rubella infection. The damage that happens to the fetus will last for the child’s whole life.

What can you do to prevent rubella while you are pregnant?

Before you get pregnant, speak to your doctor. If you are not sure whether you have had a rubella vaccine, you should have a blood test. The test will tell you if you are protected against rubella. If you have had rubella infection or have the antibodies from the rubella vaccine, you are most likely protected.

If the blood test shows you are not protected against rubella, you should get the MMR vaccine right away. You cannot get this vaccine when you are pregnant.

If you are pregnant, avoid contact with people who have rashes that cover most of their body and that have been present for less than one week.

How safe is the MMR vaccine?

• This vaccine is very safe.

• The only people who should not receive the MMR vaccine are those who have had trouble breathing or have had hives or swelling in the mouth after a previous rubella or MMR shot, and people who have illnesses that affect the immune system.

• There may be some redness, swelling or pain where the needle went into the arm or leg. Some people will have a fever and a rash, and others will have joint pains that usually last for a few days.

If you have other questions about these vaccines, ask your doctor.

For more information

“Prevention of congenital rubella syndrome”, a Canadian Paediatric Society position statement developed by the Infectious Diseases and Immunization Committee, is available at <www.cps.ca>.